When Should Palliative Care Begin?

Talking about goals of care may not be an easy conversation to have with patients with incurable conditions. They often need palliative care, which can improve their quality of life throughout the course of their disease, but healthcare professionals in progressive care units may not fully understand all of its benefits.

Jeannette M. Meyer, a hospice and palliative medicine specialist at UCLA Medical Center in Santa Monica, California, presented “Not Just for the Dying: Progressive Care Unit Patient and Family Perspectives and Palliative Care,” on Tuesday.

Meyer said the session provided attendees with approaches for pain and symptom management, ways to anticipate palliative care intervention, goals of care discussions, treatment options in progressive care and information on support services for team members.

“Many times, the nurse is the first person to pick up on the fact that a patient’s symptoms are not being controlled and that their quality of life could potentially be improved with another approach,” Meyer said. “The sooner the palliative care team is brought on board, the better. There is research that shows cancer patients have a better quality of life and live longer with earlier palliative care intervention.”

Palliative care is not just for pain control but also for the wide variety of other symptoms a patient may experience, such as nausea, vomiting, anxiety, depression and even hiccups, Meyer said. The goal of palliative care is to improve the patient’s quality of life by managing their symptoms.

“Our management of symptoms goes beyond pharmaceuticals,” Meyer said. “There are non-pharmacological therapies available from music therapy to pet therapy; they are out-of-the-box adjunctive therapies.”

Every treatment decision has risks, benefits and burdens, and progressive care can be a bridge to a desired goal; however, it is important to evaluate those goals early and provide palliative care intervention.